Interaction between Mean Arterial Pressure and HbA1c in Prediction of Cardiovascular Disease Hospitalisation: A Population-Based Case-Control Study

الملخص EN

Objective.

To explore the relationship between mean arterial pressure (MAP), HbA1c, and cardiovascular (CV) hospitalisation risk in type 2 diabetes.

Design.

Population-based case-control study.

Settings.

Primary and secondary care level in Cambridgeshire, United Kingdom.

Participants.

588 patients with type 2 diabetes from 18 English general practices recording a CV hospitalisation in 2009–2011 were included.

Risk-set sampling was used to select 2920 gender, age, and practice matched control type 2 diabetes patients.

Main Outcome Measure.

Conditional logistic regression was used to explore further dose-response relationships between MAP, HbA1c, and CV hospitalisation risk.

Results.

The relationship between MAP and CV hospitalisation was nonlinear ( P < 0.001 for linearity test).

The MAP associated with the lowest CV hospitalisation risk was 97 (95% CI: 93–101) mmHg.

An interaction between MAP and HbA1c for increased risk of cardiovascular hospitalisation was observed among those with HbA1c < 7% (53 mmol/mol) and MAP < 97 mmHg.

Conclusions.

In type 2 diabetes, MAP is a good predictor of CV hospitalisation risk.

CV hospitalisation is lowest with a MAP between 93 and 101 mmHg.

CV hospitalisation was particularly high among those with both a low MAP and a lower HbA1c.